Occupational Rehabilitation

Occupational Rehabilitation

Priority issues

While the number of people in the labour force grew steadily between 2000 and 2008, the annual number of work-related time-loss injuries (TLIs) continued to decline.

Conversely, the proportion of cases referred for rehabilitation rose yearly, increasing from 5% of all injuries in 2000 to 9% in 2008. The number of compensated rehabilitation days also continued to rise, and the duration of the compensation period increased with worker age and was longer among men.

However, proportionally speaking, the rate of referral for rehabilitation was higher among women. From 2005 to 2007, 8% of the injuries involving referral for rehabilitation accounted for 58% of all income replacement indemnity payouts.

How are the priority issues put into perspective?

Above all, we use:

statistical data

research mapping

scientific monitoring and surveillance

and we pay close attention to the needs expressed by workplaces.

Goals

Occupational rehabilitation research helps prevent or reduce the risks of prolonged disability in workers who sustain work-related injuries. More specifically, it supports the sustainable and safe return to work of workers with such injuries.

To achieve this goal, the researchers in this field study:

the various personal, organizational, administrative, and healthcare-system-related factors that affect the return-to-work process

methods of intervention for rehabilitating workers or reintegrating them into the labour force.

Four research orientations have been defined in order to achieve these goal:

Development of tools for assessing the health of workers who have sustained work-related injuries and are at risk of disability

Study of the personal, clinical, organizational, and administrative determinants of a return to work

Development and implementation of rehabilitation and return-to-work interventions

Development and implementation of strategies designed for rehabilitation and return-to-work professionals.

Current programs and themes

Protection of and support for workers in vulnerable situations

Workers in vulnerable situations are individuals who, based on their sociodemographic or occupational characteristics and the related work contexts, run a greater risk of occupational injury or prolonged disability. They include young people, aging workers, women, immigrant workers, and workers from ethnocultural minorities. The aim of this research theme over the 2013–2017 five-year cycle is to gain a better understanding of these specific categories of workers and evaluate their needs.

Risk of prolonged disability among workers

The focus of this research theme is on the worker, and the aim is to define the predictors of prolonged disability in terms of days of work absence and to target the highest-risk groups. To achieve this aim and support a prompter return to work, it is essential both to improve knowledge of the main indicators and the relationship among them and to develop prediction tools.

Support for interventions in clinical settings

The aims of this theme are first to improve interventions carried out in the healthcare system in order to ensure the most effective action possible. A second aim is to speed up the rehabilitation process so as to initiate occupational reintegration gradually or completely, while ensuring the safety of the injured workers and better adaptation of services to their specific needs.

Support for return-to-work interventions in the workplace

When workers are ready to begin a gradual or complete return to work, the various stakeholders in this process (e.g. insurer, clinical setting, employer) must be involved in order to promote a safe, sustainable return to work. The aim of this theme is therefore to develop interventions and tools that will allow these various stakeholders to play their roles optimally. The CNESST's 2010–2014 strategic plan also places particular emphasis on ways of assisting workers and supporting them in a prompt, sustainable return-to-work process.

Statistical data: priority issues explained

Of the 7,600 work-related injuries involving referral for rehabilitation annually from 2005 to 2007, the anatomical site involved in 30% of the cases was the back, representing approximately 2,200 cases a year. Of all back injuries (with or without referral for rehabilitation):

19% involved traumatic accidents

74% involved musculoskeletal disorders (MSDs)

8% could not be classified.

Back injuries involving referral forrehabilitation represented 9% and 7% of the cases associated with traumatic accidents and MSDs respectively, 58% and 55% of the respective compensated days, and 59% and 54% of the respective payouts. Nearly three-quarters of the back-related time-loss injuries (TLIs) involving referral for rehabilitation concerned manual workers. The low back region accounted for 70% of the back injuries involving referral for rehabilitation.

Among non-manual workers, the proportion of cases involving referral for rehabilitation was higher for multiple injury sites.

Again proportionally speaking, non-manual workers sustained slightly fewer sprains/strains and MSDs. Yet compared to other workers, they represented a much larger proportion of psychological disorder cases involving referral for rehabilitation.

Sprains/strains were the primary type of injury involving referral for rehabilitation. This injury type varied slightly by sex, but negligibly by occupational category and age group. Excessive exertion (mainly when lifting) accounted for 49% of the cases referred for rehabilitation and 47% of total indemnity payouts for back injuries.

In workers ages 25 and older, the 15 occupational sub-groups with the largest number of injuries involving referral for rehabilitation accounted for between 55% and 61% of all cases, total payouts, and compensated days.